Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
Active
Parent organization
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
Other names
United Community Center Geriatric Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
Authorized official
MARIA CECILIA S TAYLOR (CFO)
(414) 803-6395
Entity
Organization
Contact information
Practice address
730 W WASHINGTON ST, MILWAUKEE, WI 53204-2310
(414) 672-1353
(262) 408-5094
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353
(262) 408-5094
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1507-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649559642
—
WI
Enumeration date
08/08/2011
Last updated
05/15/2023
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